Is It Possible to Become a “Career Rehab-er?”

Rehabilitation is an important step for many people on the journey to sobriety. But is it healthy for rehab to become a repeat destination?

A woman whose son had relapsed several times raised this concern on a social media heroin support group page. She asked if it was possible her son might become a “career rehab-er” — someone trapped in the revolving door of treatment.

The Challenge of Diligence

The man’s pattern had been to enter rehab, saying he wanted to get clean, only to be asked to leave for lack of compliance. He might complete a program and move on to a sober living environment, only to be asked to leave there as well. His record of follow-through with aftercare was poor.

The man’s mother said he was in a sober house and had called to tell her he felt comfortable there. She wondered if he’d return to his pattern once the novelty wore off.

The responses from support group members were as varied as their experiences. Some who spoke up had fought addiction themselves, while others were family members who related to the mother’s situation.

Members responded with a few insights into why someone who completes a rehab program might feel compelled to return. Those with addictions might need a safe place to resist withdrawals, group members said, or they might realize once they’ve returned to their daily lives that the pull of the drug is stronger than their ability or drive to remain sober. Members also mentioned that entrenched patterns of relinquishing responsibility, as well as dysfunctional or enabling support systems, were potential pitfalls.

Maintaining the Ability to Fly

The same dynamic occurs among mental health service consumers. One clinician with decades of experience as a social worker in acute care hospitals observed that those she served would routinely be readmitted when they encountered challenges they believed they couldn’t handle.

Often these people would acknowledge that they felt safer among their peers than in the outside world, where they felt judged. Several said that having their needs met in the hospital took the pressure off them to perform to according to the higher expectations out in what they’d refer to as “the real world.”

The therapist would remind patients about the paradigm of institutionalization, in which a patient becomes so accustomed to life inside a hospital unit that he or she struggles to live successfully outside. It’s like clipping a bird’s wings, leaving it unable to fly.

A rehab stay is meant to provide therapeutic intervention and tools for maintaining recovery, but a program alone can’t resolve the addictive patterns. Rehab only interrupts these patterns to allow for on-going healing.

A Take-Home Plan for Success

To increase the chances of lasting success in addiction recovery, people in rehab should have a solid after-care plan in place before returning home. This plan might include a combination of the following factors, depending on individual needs:

• Intensive outpatient therapy
• Individual therapy
• Family therapy
• Couples counseling
• A 12-step or alternative support group program
• A sober living environment, such as a halfway house or recovery house
• Employment
• Volunteer work
• Healthy hobbies and activities
• Sober relationships — new ones or re-established ones

It’s also important to address the biological, psychological and social components of the addiction. Clinically supervised care and medication are often part of treatment, but facing daily choices and behaviors is crucial for maintaining recovery. It’s wise to avoid people, places and things linked to substance abuse rather than trying to force new behaviors into the old, potentially toxic environment.

Commit to doing whatever it takes to maintain sobriety and you’ll find your way of life is far more fulfilling once you’ve moved beyond the revolving doors of “re-rehabbing.”

By Edie Weinstein, LSW

Follow Edie on Twitter at @EdieWeinstein1